Tuberc Respir Dis.  2013 Apr;74(4):181-186. 10.4046/trd.2013.74.4.181.

A Case of Synchronous Presentation of Primary Non-Small Cell Lung Carcinoma and Pheochromocytoma

• Han JW
• Kim CH
• Jang J
• Lee HG
• Chung DC
• Choi JE
• Kim K
• Lim AL
• Song WJ
• Song YK
• Woo H
• Hyun IG
• Shin MK
• Lee YS
• Shin HS

• KMID: 1495859
• DOI: http://doi.org/10.4046/trd.2013.74.4.181

Abstract

We report a rare synchronous presentation of primary lung cancer and adrenal pheochromocytoma. A 59-year-old woman was diagnosed with right upper lobe non-small cell lung carcinoma measuring 2.8 cm and a right adrenal gland mass measuring 3.5 cm, which displayed increased metabolic activity on 18F-fluorodeoxyglucose positron emission tomography-computed tomography. The adrenal lesion was revealed to be asymptomatic. The patient underwent right adrenalectomy and histological examination revealed a pheochromocytoma. Ten days later, right upper lobectomy was performed for lung cancer. This case indicates that incidental adrenal lesions found in cases of resectable primary lung cancer should be investigated.

Keyword

Carcinoma; Lung; Pheochromocytoma

MeSH Terms

Adrenal Glands
Adrenalectomy
Electrons
Female
Humans
Lung
Lung Neoplasms
Pheochromocytoma

Figure

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  Figure 1 (A) Chest radiograph revealing focal ground glass opacity in the right upper lung. (B) Chest computed tomography displaying a 2.5×1.6-cm nodule with a spiculated border containing a partial ground glass attenuated portion in the right upper lung apical segment.

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  Figure 2 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography scan showing intense hypermetabolic activity in the right upper lobe (A) and the right adrenal gland (B), which displayed an increased uptake of 18F-FDG (standardized uptake value, 3.5).

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  Figure 3 Histology of the right adrenal mass. (A) Well-defined nests (Zellballen) are shown bound by a delicate fibrovascular stroma (H&E stain, ×100). Immunohistochemial staining is positive for synaptophysin (B), chromogranin (C), and S-100 protein (D) (B-D, ×100).

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  Figure 4 Lung tumor is revealed to be a papillary adenocarcinoma (H&E stain, ×200).

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